Abstract
Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.
Highlights
Improving accessibility, quality and utilization of Emergency obstetric and neonatal care (EmONC) services reduces maternal and neonatal mortality and morbidity.Evidence to support the usefulness of EmONC interventions in averting maternal mortality is overwhelming mostly emanating from quasi-experimental, observational and ecological designs [1]
Standard EmONC indicators include the number of basic emergency obstetric and neonatal care (BEmONC) and comprehensive emergency obstetric and neonatal care (CEmONC) facilities as measured per 500,000 population; rate of EmONC institutional births; Met need for EmONC; population Caesarean section rate, direct and indirect case fatality rate and intrapartum and very early neonatal death rates [3, 4, 11,12,13]
The study was ethically approved by the Ethical Clearance Committee of Medical Research Council (MRCC), National Institute for Medical Research (NIMR) of the Ministry of Health, Community Development, Gender, Elderly and Children
Summary
Quality and utilization of Emergency obstetric and neonatal care (EmONC) services reduces maternal and neonatal mortality and morbidity. Evidence to support the usefulness of EmONC interventions in averting maternal mortality is overwhelming mostly emanating from quasi-experimental, observational and ecological designs [1]. Interventions to reduce maternal and neonatal mortality need strong indicators to be able to Projestine Muganyizi et al.: Correlation of Obstetric Care Facility Density with Standard Emergency. Since 1991 international indicators have been developed, revised and widely used under EmONC framework in programmes aiming at reducing maternal and neonatal mortality [2,3,4,5,6,7,8,9,10]. Despite the wide application of the standard EmONC indicators, there are scanty published studies to describe the extent to which those indicators correlate with each other and with other program outcomes [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
